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Changing The Way We Die by Fran Smith and Sheila Himmel

Changing The Way We Die: Compassionate End-Of-Life Care And The Hospice Movement was written by journalists, Fran Smith and Sheila Himmel.  The two women also write a blog of the same title for the magazine Psychology Today.  After vastly different experiences in the end of life care received by each author's respective father, they decided to explore hospice as a movement and a service.  The book itself is divided into several sections that explore different aspects of the movement.

The first section explores the history of hospice both as a movement and a service provided for the dying and their families and caregivers.  This section recounts how the movement took hold in mid-twentieth century America as well as the differences between hospice in America and hospice in England where the first hospice in that country provided the spring board for its sister movement in the U.S.  It also addresses the challenges and struggles of the early movement to gain recognition, licensing, credibility, and visibility in addition to the drawbacks and challenges that continue to plague the hospice industry.  The modern evolution of hospice from a primarily and almost exclusively non-profit model based on service to a for-profit model that has spawned a billion dollar industry is also detailed.  This evolution of hospice from a movement or service to an industry is also explored in depth in the final section.

The next section presents case studies of patients' and their families' experiences with hospice.  While the next section discusses the aftermath that survivors face once their loved one dies, hospice continues to provide and care for survivors by offering bereavement services, such as counseling and group sessions.  Finally the providers are examined in depth as well as the development of training of physicians in the field of palliative medicine and hospice.

The most interesting parts of the book were the sections about the case studies and the survivors' experiences.  The other sections about the history of the movement and its evolution into a full blown industry dragged a little.  Over all it's a very informative book, and I think everyone should read it whether or not you have a family member with a terminal illness that makes the issue more urgent.  This is something everyone should think about and make plans for--what do you want the end of your life to look like, what procedures are enough, and which ones are too much.  Know what your options are.

--Reviewed by Ms. Angie

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